tci ED Coding & Reimbursement Alert - 2002 Issue 3

Reader Question: Consultations in the ED

Question: Should I use consultation codes (99241-99245) when a family physician sends a patient to the ED for evaluation of a specific complaint? If you read the CPT notes preceding the codes in the 2002 manual, it specifically states that the ED is one of the sites where consultations may be provided.Iowa Subscriber  Answer: Although consultations may be provided in the ED, documentation must support all the guidelines that govern them. A consultation is defined as a request for a medical opinion or advice about a specific condition, and is characterized by three clearly defined activities:  The...

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